Provider Demographics
NPI:1053338509
Name:HAYES, JAMES D JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:HAYES
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1960 US 1 S
Mailing Address - Street 2:#503
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-4233
Mailing Address - Country:US
Mailing Address - Phone:904-392-8462
Mailing Address - Fax:904-794-1416
Practice Address - Street 1:1960 US 1 S
Practice Address - Street 2:#503
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-4233
Practice Address - Country:US
Practice Address - Phone:904-392-8462
Practice Address - Fax:904-794-1416
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42140207P00000X
TN11970207P00000X
HIMD-4384207P00000X
GA021402207P00000X
AZ12503207P00000X
WV23464207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55117OtherBCBS
FL264257300Medicaid
WV3810014582Medicaid
D45616Medicare UPIN
FL264257300Medicaid
WV4264471Medicare PIN
P00424800Medicare PIN